title: Why do homeless people use a mobile health unit in a country with universal health care?
abstract: Mobile health units (MHUs) are an important source of health care for the uninsured; however, it is unclear what role these units play in Canada, where a universal health insurance system exists. The purpose of this study was to understand why individuals who live in a country with universal health insurance seek care at an MHU and to determine whether MHUs are used in addition to or in place of the client's usual source of care. This study investigated the use of the Rotary Club of Toronto Health Bus among 150 homeless and marginally housed adults in Toronto, Ontario, over a 3-month period. Data were collected on demographic characteristics, current and lifetime homelessness, health care use, and reasons for using the Health Bus. The majority of participants (94.6%) had a regular health care source, primarily doctor's offices (41.6%) and community health centers (16.1%); 18 (12.1%) stated that the Health Bus was their usual source of care. Participants were frequent users of the Health Bus, reporting a median of 7.0 visits (interquartile range, 3.5-12.0 visits) in the past 3 months. Most clients (86.0%) reported using the Health Bus to obtain basic supplies (eg, vitamins, socks); health problems were cited as reasons for using the Health Bus for 55 (36.7%) participants. The findings suggest that in a country with universal health insurance, MHUs supplement other sources of health care, providing essential supplies and offering important outreach services to a high-needs population.
authors.affiliation: Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Ciara
authors.initials: C
authors.lastname: Whelan
authors.forename: Catharine
authors.initials: C
authors.lastname: Chambers
authors.forename: Michael
authors.initials: M
authors.lastname: Chan
authors.forename: Sunu
authors.initials: S
authors.lastname: Thomas
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Ramos
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Hwang
keywords: community health; homeless persons; mobile health units; prevention; primary care